Ottawa takes an important first step on Inuit welfare

Posted on in Health Debates – Opinion/Editorials – The government’s promise to eradicate TB in northern communities is especially encouraging because, unlike so many previous ones, it is backed by a meaningful budgetary commitment.
March 26, 2018.   By

Gussie Bennett, a 14-year-old Inuit boy from Nain, Labrador died last week from tuberculosis, something you might have thought doesn’t happen anymore.

Indeed, in most parts of the country it doesn’t. But in northern communities the disease remains a persistent threat. An Inuit person is about 300 times as likely as a non-Indigenous Canadian to become infected with tuberculosis. And once infected, they must contend with linguistic and cultural barriers to timely diagnosis and treatment that most other Canadians do not.

Gussie did not die because transmission of the disease is impossible to control. (It has been contained in most developed nations.) Or because the disease is incurable. (It can be treated with medication.) Rather, he died in part because chronic poverty, inadequate housing and undernourishment in the North have contributed to the spread of TB and its deadly consequences in Inuit communities. And in part because the health system has failed to effectively respond.

The federal government’s promise, announced last week, that it will eradicate tuberculosis from Inuit communities by 2030 (and reduce its occurrence by 50 per cent by 2025) shows a welcome and overdue seriousness about a tragic problem that has for too long been ignored. But to succeed the government will have to make a real dent in socio-economic problems on which it has often talked big but failed to deliver.

The task of eradicating tuberculosis is enormous, both in its significance and its challenge. As Indigenous Services Minister Jane Philpott wrote in an opinion piece in the Star last week, the story of tuberculosis in the North “is part of the story of colonization in this country.”

Brought here by Europeans in the 18th century, the disease was the leading killer of Inuit people within 100 years. “Housing was often promised to Inuit as an incentive to live in sedentary communities,” writes Philpott. “Instead, scarce and inadequate housing was provided which created ideal conditions for the spread of TB and other illnesses, as well as social challenges related to overcrowding.”

These problems persist to this day. Overcrowding, poverty and undernourishment are major risk factors for contracting TB. And these are all endemic in northern communities. Nearly half of all homes in Nunavut, for instance, are overcrowded and more than 2,000 residents of the territory are on a waiting list for public housing. In Nain, where Gussie Bennett lived, housing is perpetually and dangerously sparse.

In the 1940s, when the federal government finally took some action to stop the spread of TB in northern communities, authorities transported those suspected of having the disease thousands of kilometres away to be treated. Their family members were not always informed. Some never returned. This understandably led to mistrust of the health system in many Inuit communities, and the relationship remains precarious.

Last year, a 15-year-old girl from Qikiqtarjuaq, Nunavut named Ileen Kooneeliusie died after a two-year struggle with tuberculosis. She was finally diagnosed only an hour before her death. Her family said the health-care professionals in her community could not speak Inuktitut and so she could not convince the doctors of the severity of her situation.

While the cases of Gussie and Ileen show the need for improved diagnostic techniques, which will rightly be a focus of the federal plan, their stories also shine a light on the trickier problems the government will have to deal with – cultural and socio-economic injustices at the heart of the reconciliation challenge.

The government’s promise on TB is especially encouraging because, unlike so many previous ones, it is backed by a meaningful budgetary commitment: $109 million for tackling bacterial disease in Inuit communities over 10 years. But of course the Indigenous affairs department, in its various past incarnations, has a dismal record of actually spending the money allocated to it. One key milestone, as always, will be whether the cash actually finds its way into these communities more or less on schedule and for its intended purpose. But to measurably improve the health and welfare of Inuit people, this important initiative must be seen as only a first step.

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